氨溴索联合甲泼尼龙治疗儿童哮喘急性发作的临床研究

目的 探讨氨溴索联合甲泼尼龙治疗儿童哮喘急性发作的临床效果。方法 选取2015年1月—2017年1月河南科技大学第一附属医院开元院区收治的哮喘急性发作患儿78例，随机分成对照组（39例）和治疗组（39例）。对照组静脉滴注注射用甲泼尼龙琥珀酸钠，1 mg/kg加入5%葡萄糖注射液100 mL，1次/d。治疗组在对照组治疗基础上静脉滴注盐酸氨溴索注射液，15 mg加入5%葡萄糖注射液100 mL，2次/d。两组均连续治疗7 d。观察两组患者临床疗效，同时比较治疗前后两组患者症状体征缓解时间、第1秒用力呼气容积占预计值百分比（FEV1%）、FEV1/用力肺活量（FVC）值、呼出气一氧化氮（FeNO）水平、儿童哮喘控制测试（C-ACT）评分、γ干扰素（IFN-γ）、白细胞介素-4（IL-4）和辅助性T细胞17（Th17）/调节性T细胞（Treg）比值。结果 治疗后，对照组的总有效率为79.5%，显著低于治疗组的94.9%，两组比较差异具有统计学意义（P<0.05）。治疗后，治疗组患儿喘息、咳嗽、气促、哮鸣音、湿罗音症状体征缓解时间比对照组显著缩短（P<0.05）。治疗后，两组FEV1%、FEV1/FVC值和C-ACT评分均明显增加（P<0.05），FeNO水平显著下降（P<0.05），且治疗后治疗组这些理化指标及C-ACT评分比对照组改善更明显（P<0.05）。治疗后，两组血清IFN-γ浓度显著升高（P<0.05），血清IL-4水平及外周血Th17/Treg比率显著降低（P<0.05），且治疗组IFN-γ、IL-4和Th17/Treg比对照组改善更明显（P<0.05）。结论 氨溴索联合甲泼尼龙治疗儿童哮喘急性发作疗效显著，可迅速减轻患儿症状，提高肺通气功能，改善气道炎症，缓解哮喘病情。

Clinical study on ambroxol combined with methylprednisolone in treatment of acute asthma attack in children

Objective To investigate the clinical effect of Atorvastatin Calcium Tablets combined with Trimetazidine Hydrochloride Capsules on platelet activation and endothelial function in patients with coronary heart disease. Methods Selected 153 cases of patients with coronary heart disease who were treated in our hospital from January 2015 to December 2017, divided into two groups randomly. The control group oral Atorvastatin Calcium Tablets, observation group combined with Trimetazidine Hydrochloride Capsules. Platelet activation and vascular endothelial function in two groups before and after treatment were compared.Results The effective rate of the observation group was significantly higher than control group (P<0.05). After treatment, the levels of GMP-140 and vWF were significantly decreased (P<0.05), and the levels of GMP-140 and vWF in the observation group were significantly lower than control group (P<0.05). The plasma endothelin level of the two groups decreased significantly after treatment (P<0.05), and the observation group was more significant (P<0.05). Conclusion s Atorvastatin Calcium Tablets combined with Trimetazidine Hydrochloride Capsules can effectively inhibit platelet activation and improve endothelial cell injury in patients with coronary heart disease.